Evaluation Of Sleep In Adults With Neurodevelopmental Disorders

Grainne McAlonan

King's College London

I am a an academic clinician (Reader) with a PhD in Neuroscience. My research focus is on neurodevelopment disorders including Autism Spectrum (ASD). I use MRI as a tool to link brain and behaviour in people with conditions such as ASD. My research agenda is informed by the patients with neurodevelopmental disorders that I see in the National ADHD and Autism Service for Adults at the Maudsley Hospital.As Head of Research within the Behavioural Developmental Psychiatry (BDP) Clinical Academic Group (CAG) of South London and Maudsley NHS Foundation Trust, I aim to fully integrate research into neurodevelopmental disorders such as ASD with clinical practice. The BDP CAG agenda I promote has the following objectives:I. To examine the causes of neurodevelopment disorders, starting as young as before birth.II. To develop and evaluate novel diagnostic and treatment response prediction toolsIII.To advance new strategies (including pharmacological) for intervention and prevention

Abstract

Introduction: Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are often associated with sleep problems. However, there is limited understanding of sleep difficulties in these conditions,... [ view full abstract ]

Introduction: Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are often associated with sleep problems. However, there is limited understanding of sleep difficulties in these conditions, especially in adults.Methods: Well validated sleep questionnaires [The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI)] were completed by 164 (111 male, 53 female) adults attending ASD and ADHD specialist diagnostic services at the Hospital. Thirty had ASD; 98 had ADHD; 34 had ASD and ADHD. Clinical symptoms of ASD, ADHD, depression and anxiety were rated using the Autism-spectrum Quotient (AQ), Barkley's scale, and the Hospital Anxiety and Depression Scale (HADS), respectively.Results: 91% had "poor" sleep on the PSQI (total score 5+); 44% had either "moderate" or "severe" insomnia on the ISI (score 15+) regardless of diagnosis. High Insomnia scores across the sample correlated with high HADS Anxiety scores (r=0.477, p=0.001); but not Depression scores. High Insomnia scores also correlated with more symptoms of hyperactivity (r=0.380, p=0.001); but not inattention. The relationship between PSQI scores and symptoms was similar. Anxiety scores tended to be higher in those with ASD (p=0.055); Barkley hyperactivity scores were significantly higher in those with ADHD (t-test, p=0.009).Conclusions: This preliminary study indicates a similar high burden of sleep disturbances in adults with ADHD and ASD. However the origins may be different in each condition, with important implications for management. Further work to characterize the causes of, and possible interventions for, sleep disorders in adults with neurodevelopmental conditions is therefore underway.

Ethics and permissions statement and / or disclosure of potential conflict of interest (if relevant)

U.K. National Research Ethics Committee Reference: 12/LO/0790 All authors declare no known conflict of interest, financial or otherwise. [ view full abstract ]

U.K. National Research Ethics Committee Reference: 12/LO/0790All authors declare no known conflict of interest, financial or otherwise.